Subcrestal Iliac-Screw: A Technical Note Describing a Free Hand, In-line, Low Profile Iliac Screw Insertion Technique to Avoid Side-connector Use and Reduce Implant Complications

Spine
Gabriel LiuHee-Kit Wong

Abstract

Case-series. To report our modified iliac-screw insertion technique and its clinical outcomes. Iliac-screws are one of the preferred methods for modern spinopelvic-fixation. However, the technique is not without complications, predominantly because of iliac-screw head prominence, leading to pain and revisions. Conventional iliac-screw entry point is sited superficially at the posterior-superior-iliac-spine (PSIS) contributing to screw-head prominence. We propose a more low-profile, subcrestal entry point that is more medial and inferior to the PSIS at the medial wall of the iliac crest, lying underneath the crest but above the sacroiliac joint. This position keeps the screw-head low profile and in-line with proximal instrumentation to ease rod engagement. Ten consecutive patients who underwent spinal deformity correction surgery using the modified iliac-screw entry point fixations were enrolled. Clinical, radiological, and surgical parameters were reviewed. Five males and five females with average age of 66 years and average follow up of 29 months were reviewed. Mean preoperative Cobb angle and C7-SVA were 32.1° and 10.3 cm, respectively. Surgical indication was progressive deformity and neurogenic claudication in eight cases a...Continue Reading

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Citations

Mar 9, 2021·Injury·E Sevillano-PerezM Prado-Novoa
May 15, 2021·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Ziwei GaoQiang Yang
Jul 14, 2020·Zeitschrift für Orthopädie und Unfallchirurgie·Rene HartensuerMichael Raschke
Jan 4, 2022·Journal of Investigative Surgery : the Official Journal of the Academy of Surgical Research·Yangxing LuoChengla Yi

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